Introduction
The global community is in a crisis, struggling to contain the COVID-19 pandemic. As of June 2021, a total of four million people worldwide have succumbed to COVID-19, leaving many orphaned or struggling with (post-)COVID-19 challenges. While the adverse implications of this pandemic have hit the rich and poor countries alike, the average death toll as a proportion of those infected in poorer countries is generally higher. Two major reasons for the high death toll are a lack of effective treatment options and infection prevention. There are no newly developed and approved therapeutic agents for COVID-19. Although treatment may vary across nations, combinations of antivirals, antibiotics, corticosteroids, blood thinners, and several other agents that together provide some relief are used. There is presently no known cure for COVID-19. There has been a race towards the development of vaccines against SARS-CoV-2, and so far, several have been given emergency-use authorisation that has largely benefitted the Western nations. Access to vaccines in poorer countries is low, and where vaccines are available, their roll-out is slow. With the ever-changing variants, there is presently no indication that there is an end in sight to the pandemic, at least for the developing nations, as each variant seems to spread faster than the previous one. For Botswana and most of the developing nations, the reality is that current mitigation strategies have, at best, minimal positive impact on infection, hospitalisation, and mortality rates. Given our small population and limited resources, we must urgently search for and accommodate other therapeutic options. A therapeutic agent that has attracted worldwide attention is Ivermectin as the leading candidate. Ivermectin has been demonstrated to have both antiviral and anti-inflammatory properties, which explains its use against COVID-19, a viral disease associated with heightened inflammation. There is variability in the quality of studies reported and hence some researchers and institutions, such as the USA’s National Institute of Health, Food and Drug Administration, Merck, and World Health Organisation (WHO), have either been neutral to or against the use of Ivermectin on COVID-19 patients. There is, however, a growing body of literature from reputable groups of researchers around the world showing a degree of benefit with the use of Ivermectin in the prevention and treatment of COVID-19. Ivermectin, which is available in tablet form, is relatively cheap and has been widely used as an antiparasitic agent in humans since 1987, with an estimated four billion-plus prescriptions since then, underlining its safety profile. Indeed, Ivermectin is on the list of essential medicines published by WHO.
